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Erschienen in:
06.09.2024 | Original Communication
The role of 7 T MRI to assess atrophy of the subcortical deep gray matter in relapsing–remitting multiple sclerosis
Erschienen in: Journal of Neurology | Ausgabe 10/2024
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Background
Deep gray matter (DGM) atrophy and lesions are found in multiple sclerosis (MS).
Objective
To optimize automated segmentation for 7 T DGM volumetrics and assess sensitivity to atrophy and relationship to DGM lesions and disability in relapsing–remitting (RR) MS.
Methods
30 RRMS subjects [mean age 44.0 years, median Expanded Disability Status Scale (EDSS) score 2] and 14 healthy controls underwent 7 T MRI with 3D magnetization-prepared 2 rapid gradient-echoes (MP2RAGE) and fluid-attenuated inversion recovery. Customizing an automated pipeline to assess DGM structure volumes required pre-processing combining two MP2RAGE inversion times and uniform T1 images, and noise-suppressed reconstruction. DGM volumes were normalized. Brain DGM lesions and white matter T2 lesion volume (T2LV) were expert-quantified. Spearman correlations and Wilcoxon rank-sum tests were assessed.
Results
DGM lesions were found in 77% (n = 23) of MS subjects and no controls, with thalamic lesions most prevalent (73%). An average of 3.6 DGM lesions was found per person with MS. Total DGM volumes were lower in MS vs. controls (p = 0.034), varying by region, most pronounced in the caudate (p = 0.008). DGM volumes inversely correlated with EDSS (total DGM: r = – 0.45, p = 0.014; globus pallidus: r = – 0.42, p = 0.023; putamen: r = – 0.44, p = 0.016; caudate: r = – 0.37, p = 0.047) and T2LV (total DGM: r = – 0.53, p = 0.003; putamen: r = – 0.40, p = 0.030; thalamus: r = – 0.63, p < 0.001). DGM atrophy was most closely linked to disability among all MRI measures. Thalamic lesion volume correlated inversely with thalamic volume (r = – 0.38, p = 0.045).
Conclusion
7 T MRI shows a link between DGM atrophy and both white matter lesions and physical disability in RRMS. Thalamic lesions are associated with thalamic atrophy.
